Hospice Denied: Is That Nursing Home Abuse?

Dear Doctor:

I’m writing you to complain about your treatment of my friend Kathleen Smith (not real name).

She died June 5, 2007. She was your patient. I called your office shortly thereafter to let them know. I also called social security and Secure Horizons.

You probably have hundreds of patients so you may not recall Kathleen Smith. Even though she was under your care for more than 10 years, she’s probably just a patient file number to you – if that.

You may recall that I tried to get her hospice services and you were vigilantly against that last courtesy to give her some comfort.

I called your office for over a week asking if she could get hospice services. When someone called me back, my requests were routinely denied. When I brought Kathleen to her appointment in May 2007, you screamed, “She (pointing your finger at me) wanted to put you in hospice!”

Two days after her doctor’s appointment with you, she was admitted to the hospital with pneumonia. Her breathing was not an issue during the appointment or perhaps you were so angry that I wanted her to get some respite, her breathing difficulty was overlooked.

I have had pneumonia on three occasions and I know pneumonia symptoms don’t develop overnight.

She received excellent care at XYZ Hospital (not real hospital). They thought she was a goner but she fought on. She again ended up at ABC Care Center (not real name) and she again thought she was going home to the substandard 24/7 non-medical care that she was receiving at an outrageously out-of-pocket expense.

A board and care facility in Garden Grove was recommended. Apria delivered a wheel chair and a walker to her residence instead of the board and care facility. We didn’t request a walker because it was evident to me – a non medical person – and the R.N. who owned the board and care facility, that Kathleen would never walk again.

A physical therapist came to the board and care facility. SHE NEEDED HOSPICE! The physical therapist admitted so. Finally, two days later on Mrs. Smith’s death bed as she was turning clammy and blue and gasping for air -- hospice was granted.

At that point, hospice was more for me than Kathleen who lay dying as I held her hand. Hospice was there for me. I was relieved that Kathleen was getting relief and mourned that she could not get hospice help when she was alive and so desperately needed it.


I told the hospice nurse my horror story about trying to get hospice from your office and she just shook her head. I also told the same horror story to all Kathleen’s friends. And now, I’m telling the world that denying hospice and denying dignity at the end of life is what I consider a form of medical and nursing home abuse.

Kathleen was dying. She needed hospice whether it was in a facility or in her home. You, her doctor, seemed to be the only person unaware of how badly she needed this service to make her last weeks and days comfortable.

You denied her of that necessity, of that comfort.

I hope you read the letter that I sent to your office months ago. I hope the CEO of the XYZ Hospital read it as well as the social workers. I hope there is some training for arrogant doctors like you to learn about the benefits of hospice and how not to bully family members and POAs when they request it.

Kathleen’s neighbor who was a former hospice worker urged me to get hospice. She was right, and you, Doctor, was wrong.

I will forever fault how you failed her in the end by not allowing her last weeks and days to be more caring and giving and for not allowing her not to suffer and her inability to die with dignity.


Karyn Z

Why Does Nursing Home Abuse Occur?

The reasons why nursing home abuse occurs is explored

To many, the concept of abusing the elderly is beyond repellant. To bring harm down upon an older, infirmed person is outright disgraceful. This is why people are so shocked when they discover instances of nursing home abuse. Many then will wonder why nursing home abuse exists and why instances of it are not exposed. There are a few reasons why….

Nursing homes are insulated environments that exist far away from the prying eyes of the public. After all, nursing homes are private property and those who reside in such homes have a reasonable expectation to privacy. So, it is doubtful wandering eyes will be permitted into such an environment. While this is a good thing, it also makes it difficult for instances of abuse to be noticed. This is why anyone who is visiting a relative in the care of a nursing home should be vigilant enough to notice anything that seems out of the ordinary or would hint at abuse.

The other reason is the fact that the residents of the nursing home may be incapable of articulating any nursing home abuse that may be occurring. Keep in mind many of these elderly people have physical and mental ailments that may preclude their understanding of any abuse they suffer. There are those situations where the residents may be silent out of abject fear. This makes raising awareness of a frightening situation somewhat limited.

When instances of nursing home abuse are brought to your attention, it is critical to seek legal action against anyone who may have committed the egregious behavior. If for no other reason any judgment made in such a case will have a ripple effect throughout the profession. This may lead to a number of less than stellar nursing homes to provide an environment that is safe for all its residents.